Evidence map›Paper›PMID 32873250›Full record

ArticleBMC neurology2020

Mechanical thrombectomy: can it be safely delivered out of hours in the UK?

Jake Weddell, Emma Parr, Stacey Knight, Girish Muddegowda, Indira Natarajan, Jayan Chembala, Phillip Ferdinand, Nasar Ahmad, Zoltan Pencz, Saad Rana and 7 more

Open access · goldAbstract read
In one paragraph

Article in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Investigating the "Weekend Effect" on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 2 institutions in 1 country.

Jake WeddellDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK. jakeweddell2@gmail.com.ORCID https://orcid.org/0000-0002-9913-9082
Emma ParrDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Stacey KnightSchool of Medicine, Keele University, Newcastle-under-Lyme, ST5 5BG, UK.
Girish MuddegowdaDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Indira NatarajanDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Jayan ChembalaDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Phillip FerdinandDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Nasar AhmadDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Zoltan PenczDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Saad RanaDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Anushka WarusevitaneDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Changez JadunDepartment of Radiology, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Sanjeev NayakDepartment of Radiology, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Zafar HashimDepartment of Radiology, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Albin AugustineDepartment of Anaesthetics, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.
Julius SimSchool of Medicine, Keele University, Newcastle-under-Lyme, ST5 5BG, UK.ORCID https://orcid.org/0000-0002-1816-1676
Christine RoffeDepartment of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.ORCID https://orcid.org/0000-0002-5259-6649
Royal Stoke University Hospital · GBKeele University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMechanical thrombectomy was approved by NICE as a treatment for stroke in 2016. However, most of the evidence is from studies conducted during working hours. Only few centres in the UK perform thrombectomies out-of-hours. The Royal Stoke University Hospital (RSUH) has offered thrombectomies over 24 h (24/7) since 2010. The aim of this service review is to compare the outcomes for patients treated in regular working hours to those treated outside normal working hours within this unit.

methodsThis retrospective service analysis includes all patients treated with mechanical thrombectomy at RSUH since the start of the service in January 2010 to June 2019. Data on key demographics, timings, procedural complications, and long-term outcomes including death and disability at 90 days were collected. In-hours was defined as the time between 8:00-17:00 h, Monday to Friday; out-of-hours was defined as any time outside this period.

resultsIn total, 516 mechanical thrombectomies were performed in this time period; data were available on 501 of these. Successful recanalization (TICI 2b/3) was achieved in 86% of patients. By 90 days 96 (19%) had died and 234 (47%) were functionally independent (modified Rankin Scale score ≤ 2). 211 (42%) of the procedures were performed in-hours and 290 (58%) out-of-hours. Door-to-CT and door-to-groin times were significantly longer out-of-hours than in-hours, but thrombectomy duration was significantly shorter. There were no significant differences in complications and short- and long-term outcomes.

conclusionMechanical thrombectomy was delivered safely and effectively 24/7 in this UK hospital, with no difference in clinical outcomes.

Indexed as

After-Hours CareAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesStrokeThrombectomyTreatment OutcomeUnited KingdomLarge vessel occlusionMechanical thrombectomyStroke

Identifiers

PMID32873250
PMCPMC7461259
OpenAlexW3082873650

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.